Prevalence of musculoskeletal injuries among university undergraduates following Sri Lankan traditional dancing

Dancing is a demanding form of art that consists of a purposefully selected series of human movements presented in a rhythmic way. However, Dancers represent a medically under-served occupational group who are at high risk for work-related musculoskeletal disorders. Injury prevention among dancers has become challenging due to the dearth of research in the field. Therefore, a cross-sectional survey to determine the prevalence of musculoskeletal injuries among Sri Lankan traditional dancers is vital of need. The main objective of this research was to evaluate the prevalence of common musculoskeletal injuries among university undergraduates who follow Sri Lankan traditional dancing. This study was a cross-sectional descriptive study that included undergraduate students from four local universities. Stratified sampling method was used to select 293 participants and an online questionnaire was used to collect data. Among the three types of traditional dancing styles, many were following Kandyan dancing: 45.1%. Out of the study sample, 190 dancers (64.84%) reported injuries with males indicating the highest rate of injuries (36.87%). The most common injury types reported were strain and sprain. Kandyan dancers reported the highest number of injuries (p<0.025), contributing to the highest rate of injury due to strains (19.45%). Twirls and prolonged mandiya positions are found to be the common mechanisms that cause injuries. Only 10.6% of the participants approached physiotherapy treatments after an injury. According to the findings of the current study, there is a significant rate of dancing-related injuries among Sri Lankan traditional dancers.

Dancing is a demanding form of art that consists of a purposefully selected series of human 14 movements presented in a rhythmic way. However, Dancers represent a medically under-served 15 occupational group who are at high risk for work-related musculoskeletal disorders. Injury 16 prevention among dancers has become challenging due to the dearth of research in the field. 17 Therefore, a cross-sectional survey to determine the prevalence of musculoskeletal injuries among 18 Sri Lankan traditional dancers is vital of need.

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The main objective of this research was to evaluate the prevalence of common 20 musculoskeletal injuries among university undergraduates who follow Sri Lankan traditional 21 dancing. This study was a cross-sectional descriptive study that included undergraduate students 22 from four local universities. Stratified sampling method was used to select 293 participants and an 23 online questionnaire was used to collect data.

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Among the three types of traditional dancing styles, the majority were following Kandyan  According to the findings of the current study, there is a significant rate of dancing-related 32 injuries among Sri Lankan traditional dancers.

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Dancing is a challenging form of art that consists of a rhythmically presented succession of 39 purposefully selected series of human movements. Dancing necessitates a lot of practice, balance, 40 motor coordination, and extremes of joint range of motion.

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There are various types of traditional dancing styles such as ballet, Bharatanatyam, 42 ballroom, contemporary, hip hop, jazz, tap dance, folk dance, Irish dance, modern dance, and 43 swing dance. A dance form is designed with elements of traditional culture such as music, 44 literature, and legends [1]. The origin of traditional dancing in Sri Lanka goes back to immemorial 45 times of native tribes: 'Yakkas', thus, imposing a paramount importance in Sri Lankan fine arts.

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There are three main styles in Sri Lankan traditional dancing: 'Kandyan dancing' or 'Udarata 47 Natum' of the hill country origin, 'Low country dancing' or 'Pahatharata Natum' of the southern 48 plains origin, and 'Sabaragamuwa dancing' which originated in Sabaragamuwa province [1]. 49 There are some variations in techniques and skills in these three traditional dance styles  traditional dancing as well as approaches followed when returning to dancing after an injury should 78 be carefully studied to minimize the injury rates. Although several studies have been carried out 79 on typical musculoskeletal disorders associated with many traditional dancing forms, no research 80 has been done on dance related injuries in Sri Lanka. Since there are three main types of traditional 81 dancing in Sri Lanka, the injury prevalence, injury mechanism, and the site of injury may vary 82 with regard to the style. Therefore, a cross sectional survey to identify the musculoskeletal injuries 83 prevailing among Sri Lankan traditional dancers was proposed in this study.

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Undergraduates who follow Sri Lankan traditional dancing were taken as the study sample 85 in the present study because they show less age-related physiological changes and the young can  The sample size for the study was 293 which was calculated using Solvin's formula [7]. The

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Characteristics of the participants 136 The mean age of the participants was 23 (1.6) years and the majority was females at 64.5%. Among  whereas; sprain was more common among Low country and Sabaragamu dancers.

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When the prevalence of injuries in each dancing style was assessed, strains, subluxations, sprains, 158 and other injuries showed significant associations with the type of traditional dancing style. Males 159 reported a substantially higher overall injury rate than that of females according to the prevalence 160 of injuries with relevance to the gender. Further, sprain is the most common type of injury in males, 161 while strain is the most common in females (Table 3). ankle were the most prevalent injury sites among Kandyan dancers (Table 4).    the sites which are more prone for injuries including lower back and foot [18,19]. The ankle has 224 been identified as a common site for injuries in many of these studies as the body weight shifts to

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According to the results of the study, twirls and prolonged mandiya position were found to be the 242 common movements that cause higher rate of injuries among traditional dancers in Sri Lanka.

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Twirls caused majority of injuries in low country dancers as it is a basic movement of the style.